Facet Joint Pain

Facet joints are small joints along the spine's posterior aspect, with two per vertebral level. They guide spinal movement and bear approximately 20% of body weight, with the disc and vertebral body handling the remaining 80%.

How Facet Joints Become Painful

Pain can develop through direct trauma or gradual biomechanical imbalances. Common contributing factors include:

• Weak abdominal and core muscles
• Tight back muscles pulling on the facet joints
• Excessive anterior pelvic tilt from tight hip flexors
• Leg length discrepancies and scoliosis creating asymmetric loading
• Disc degeneration causing micro-instability that increases facet load

Once inflamed, facet joints create a cycle: inflammation causes muscle guarding and stiffness, restricting movement and increasing pressure on the joint, which predisposes it to further arthritis. These are synovial joints that require movement for proper lubrication.

Symptoms

The defining characteristic of facet pain is discomfort that is aggravated by backward bending (extension) and relieved by bending forward (flexion). An acute "facet lock" involves jamming of a single joint, producing sharp, stabbing localised pain that severely limits movement. Chronic facet hypertrophy causes a deep, nagging pain slightly to the side of the spine, potentially radiating to the upper leg, buttock, shoulder, or upper arm.

Treatment

Acute facet lock usually improves with rest but responds well to spinal manipulation for immediate relief. Chronic pain management includes postural correction, core strengthening, orthotics, dry needling, stretching, and massage. More invasive options include X-ray guided injections and radiofrequency denervation for severe cases.

Call us on 020 8506 1000 to discuss facet joint pain assessment.